Payment system reforms have become an important part of Chinese healthcare reforms, and global budget has been seen as a major trend. Based on the practice and data of four pilot hospitals in Beijing which have implemented the global budget, this paper focuses on analyzing the effects of implementation on the following aspects and provides references for policy improvements: medical services, average medical cost, total health expenditure, medical cost structure, average length of stay and out-of-pocket expense percentages.

AIM: To investigate the clinical effect of phacoemulsification and intraocular lens ( IOL ) implantation for cataract patients after corneal refractive surgery, and to compare the accuracy of the different refractive IOL.
METHODS:The data of 120 myopia cases (160 eyes) in our hospital, who underwent cataract surgery and corneal refractive surgery were analyzed. Corneal curvature K value before corneal refractive surgery were obtained and calculated by using history method. Corneal curvature correction numerical method and corneal topography were used to record K value of patients with incomplete data before and after treatment. The K value was substituted into the formula. By comparing the actual cataract surgery and refractive state expected refractive status (-0. 50D), the accuracy of IOL refractive obtained from three methods was compared.
RESULTS: The average best corrected visual acuity before cataract surgery was 0. 25 ± 0. 05, and it was improved ( 0. 80 ± 0. 05 ) after surgery. The average spherical equivalent (SE) was -1. 98±1. 75 before surgery and +0.85±3.38 after surgery (P<0.05). The K values of 48 cases were calculated by clinical history method ( CHM ) and that of 73 cases was calculated with the adjusted keratometry method ( AKM) . The K values of 39 cases were calculated using the corneal topography method ( CTM) .
CONCLUSION: For patients with corneal refractive surgery, the appropriate method can be selected according to clinical symptoms, history, etc. and this may help to accurately calculate IOL. For patients with complete data, CHM can be used to provide corneal K values, while for those with incomplete data, AKM and CHM can be used.

Objectives To explore the effects of control measures and dynamic prevalence of drinking water endemic fluorosis in China, to provide basis and technique support for endemic fluorosis control in China. Methods The survey was carried out according to the national surveillance Scheme of Endemic Fuorosis. The fulfillment of control measures and the quality of water improving projects were surveyed. Household water sample and urine of children aged 8-12 years were collected and fluoride content was detected by iron selective electrode method. Check the teeth of children aged 8-12 years. Dental fluorosis was diagnosed by Dean's method. Results projects were build in 84 endemic villages in 2006, and the average water improving rate came to 73.98% fluoride contents of half the surveyed spots were over the standard, mainly between 1.0-2.0 mg/L, and the urine controlled just in only few spots and it was in moderate or severe status in some endemic areas for many years. Conclusions Little progress of control measures in drinking water endemic fluorosis counties surveyed has been made in these two years. Projects of running out of status and over standard of water fluorosis are frequently seen. Dental fluorosis in many spots is not controlled.

Medical metrology work is the base of quality control for hospital medical equipment.It guarantees the accuracy of hospital medical instruments.It is important to set up a complete management system for hospital metrology institutions.

Objective:To study the relationships between age,the state of genital tract and vaginitis,cervical erosion and vulvae leukoplakia in married women.Methods:Gynecologic inspection and laboratory examination were performed in 1 253 patients diagnosed vaginitis,cervicitis and vulvae leukoplakia in a women screen in a certain area in Chongqing in 2007.Statistics analysis was made by SAS8.1.Results:Of 1 253 patiens,45.89% had vaginitis,44.69%,cervical erosion,and 3.35%,vulvae leukoplakia,6.07%,the other conditions.Age,vaginal cleanness degree,candida infection were risk factors of vaginitis;Age,vaginal cleanness degree were related to cervical erosion and vulvae leukoplakia.Conclusion:Vaginitis,cervical erosion and vulvae leukoplakia should arouse more attention in the prevention and treatment of women genital tract disease in the future,and the standard etiology treatment should be performed to get microcosmic ecological balance.The perfect control and monitoring system for gynecologic disease should be established,and service quality of women health care should be improved.

Video assisted thoracic surgery(VATS) was rapidly developed in recent years.It's been widely accepted because it was minimally invasive and the patients were fast recovery with a survival rate similar to routine thoracotomy patients.However,more and more attention was paid to the side effect of general anesthesia with double cavity intubation during the surgery.Nonintubated thoracoscopic surgery for lung cancer was progressively developed.This surgery method decreases the side effect compared to general anesthesia with double cavity intubation.However,more surgical difficulty,additional surgical risk and prolonged surgery time were all inevitable become disadvantages of this new method.The less side effect of general anesthesia for patients and the more challenge for thoracic surgeon was brought simultaneous by this new method.More clinic trial should be implemented in validating the advantages and disadvantages.

Purpose　To judge the value of CT in the diagnosis of acute pancreatitis. Methods　74 cases of acute pancreatitis confirmed by operation were reviewed. All patients underwent CT plain and contrast -enhanced scanning. Oral contrast agents were used. Results　According to clinical diagnosis, they were devided into edematous type(n=53),and necrotic type(n=21). 7 cases were complicated with abscesses, and 5 cases died. According to CT finding, Grade A,n=10; Grade B,n=16; Grade C,n=19; Grade D,n=16; Grade E, n=13. Conclusion　 CT is valuable in the diagnosis of acute pancreatitis, and CT grade is referable.

Objective:To evaluate the curative effect of electroacupuncture on postapoplectic incontinence of urine.Methods:One Hundred and fifty-five patients were randomly allocated into a treatment group of 102 cases and a control group Of 51 cases.The treatment group was treated with electroacupuncture and the control group with Wlestem medicine.The curative effects were evaluated after 1-2 months.Resuits:The basic cure rate.marked eriective rate,effective rate and inelyective rate were 47.0%,27.5%,1 8.6% and 6.9% respectively,with a total effective rate of 93.1%in the treatment group and 7.9%,1 7.6%,1 7.6% and 56.9% respectively,with a total effective rate of 43.1% in the control group.There was a statistically significant difference in curative effect between the two groups(P＜0.05).The curative effect was significantly beaer in the treatment group than in the control group.Conclusion:Electroacupuncture has a good curative effect on postapoplectic incontinence ofurine.

Bone Marrow Mesenchymal Stem Cells (BMSCs) are ideal seed cells for cell therapy,which have been through many long-term studies of in vitro and animal disease model treatment and have been widely used in preventing and treating a variety of clinical diseases caused by aging and other damage,including bone injury and regeneration,neural degenerative and injury,myocardial injury,liver cirrhosis,diabetes,lung disease and so on.BMSCs application in the treatment of orthopaedic disease is the most common and effective.By retrospective literature review,we summarize the BMSCs transplantation application in Orthopaedic disease treatment.As an ideal cell source,BMSCs was first applied in bone tissue engineering,mainly used in the treatment of long bone defect and bone nonunion;Recently,the research trends of clinical BMSCs application turned to treat degenerative diseases and genetic disorders because of its great potential,including osteoarthrits,femoral head necrosis,disc degeneration,spinal cord injury,knee varus,osteogenesis hypoplasia,hypophosphatasia and so on.The safety and efficacy of BMSCs treatment are the key issues in clinical cell therapy.There is no side effects and complications after BMSCs treatment,prove its clinical application is safe.But due to type and degree of disease and individual differences,therapeutic methods including injection method,effective concentrations,treatment window selection,cycle and therapeatic effects have a bigger difference.There is still no uniform of recognized operation standards for the treatment of the same type of disease.So BMSCs transplantation requires effective control during whole medical process and its application in orthopedic diseases is still lack of large-scale multicenter clinical study.Therefore,this review focuses on induction,summary and analysis in the research status of BMSCs in bone disease treatment,and provide new ideas and methods for BMSCs transplantation in orthopaedic disease prevention and treatment.

Objective To understand the death level and main death causes among residents in the Wansheng Economic De‐velopment Zone to provide the basis for comprehensive prevention and control .Methods According to the ICD‐10 international classification of diseases ,the death causes were classified and coded for statistically analyzing the crude mortality rate ,standardized mortality rate and the death causes constituents in this surveyed population .Results The crude mortality rate of residents in Wan‐sheng Economic Development Zone during 2014 was 650 .57/100 000 and the standardized mortality rate was 413 .35/100 000 .The sequence of death causes was circulatory system disease ,respiratory system disease ,tumor ,injury and poisoning and digestive sys‐tem diseases .The death number for these 5 kinds of death causes accounted for 93 .21% of the total death number .The top five of potential life loss years were injury and poisoning ,tumor ,circulatory system disease ,respiratory system disease and digestive system diseases .The rates of potential years of life loss were 13 .76‰ ,10 .19‰ ,8 .35‰ ,4 .84‰ and 2 .69‰ respectively .Conclusion Chronic noncommunicable diseases ,injury and poisoning become the main causes of death in the Wansheng Economic Development Zone and disease burden .